• Title/Summary/Keyword: myelitis

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A Case Report on a Neuromyelitis Optica Patient with Painful Tonic Spasm and Decreased Motor Function Improved by Korean Medicine Treatment Including Dokwhalgisaeng-tang (시신경척수염으로 인한 통증긴장연축과 하지 운동기능 저하를 호전시킨 독활기생탕을 포함한 한의치료 증례 보고 1례)

  • Kim, Du-ri;Yun, Jong-min
    • The Journal of Internal Korean Medicine
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    • v.39 no.2
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    • pp.130-138
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    • 2018
  • Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder of the central nervous system characterized by optic neuritis and longitudinally extensive myelitis. Painful tonic spasm is a common complication of NMO, but there have been no reports about it in Korean medicine studies. In this case, we treated a 53-year-old woman diagnosed with NMO with paraplegia, painful tonic spasm, and decreased visual acuity using Korean medicine treatment, including acupuncture, herbal medicine, cupping, and moxibustion. We measured changes in clinical symptoms using the manual muscle testing (MMT), the numeric rating scale (NRS), the modified Barthel Index (MBI), and the Functional Independence Measure (FIM). After treatment, clinical symptoms were improved. The results indicate that Korean medicine treatment may be effective in the treatment of an NMO patient with paraplegia and painful tonic spasm.

A Case of Cerebral Infarction Associated with Mycoplasma pneumoniae Infection (Mycolasma pneumoniae 감염에 의한 뇌경색증 1례)

  • Ahn, Young Joon;Choi, Ki Cheol;Yang, Eun Seok;Park, Yeong-Bong;Park, Sang-Gi;Moon, Kyung Rye;Kim, Young Sook
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.308-312
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    • 1998
  • Mycoplasma pneumoniae infection is usually confined to the respiratory tract but it can cause a variety of extrapulmonary manifestations such as rashes, myalgia, hemolytic anemia, cerebral infarction, transverse myelitis, cerebellar ataxia, Guillain-Barre syndrome and meningoencephalitis. Neurologic complications of Mycoplasma pneumonia have been rarely reported until now. Cerebral infarction as a complication of mycoplasma infection in children has been very rarely reported. In our case, in a young girl with M. pneumoniae infection, a cerebral infarct resulted in persistent and significant neurological dysfunction. We report a 11-year-old girl with cerebral infarction associated with clinical and serologic evidence of Mycoplasma infection.

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Paraplegia following Epidural Steroid Injection -A case report- (경막외 스테르이드 주입후 발생한 하지마비 -증례 보고-)

  • Chung, So-Young;Song, Jang-Ho;Lee, Mi-Ra;Lee, Hong-Sik;Park, Dong-Ho
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.106-112
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    • 1994
  • This report documents a case of paraplegia which apparently occurred following epidural injection of triamcinolone (40 mg) and 0.125% bupivacaine(10 ml). The patient's condition was progressive until she experienced paraplegia and dissociative sensory loss below T5(Rt) and T10(Lt) dernatomes, along with urinary and fecal incontinence lasting 24 hours. CT and MRI were normal. Three months after the onset of paraplegia, the patient could only slightly move her legs. After 8 months of the initial paraplegia, she was able to walk with assistance, and to perceive pinrick sensation in her right leg, and tingling in her left leg. She could also void and defecate. At 16 months, paraplegia and sensory loss were slightly recovered. The cause for this paraplegia is still unknown, but it may be from exacerbation of preexisting disease, acute transverse myelitis, anterior spinal artery syndrome, or neurotoxicity.

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Myelin oligodendrocyte glycoprotein antibody-associated disorders: clinical spectrum, diagnostic evaluation, and treatment options

  • Lee, Yun-Jin;Nam, Sang Ook;Ko, Ara;Kong, JuHyun;Byun, Shin Yun
    • Clinical and Experimental Pediatrics
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    • v.64 no.3
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    • pp.103-110
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    • 2021
  • Inflammatory or immune-mediated demyelinating central nervous system (CNS) syndromes include a broad spectrum of clinical phenotype and different overlapping diseases. Antibodies against myelin oligodendrocyte glycoprotein (MOG-Ab) have been found in some cases of these demyelinating diseases, particularly in children. MOG-Ab is associated with a wider clinical phenotype not limited to neuromyelitis optica spectrum disorder, with most patients presenting with optic neuritis, acute disseminated encephalomyelitis (ADEM) or ADEM-like encephalitis with brain demyelinating lesions, and/or myelitis. Using specific cell-based assays, MOG-Ab is becoming a potential biomarker of inflammatory demyelinating disorders of the CNS. A humoral immune reaction against MOG was recently found in monophasic diseases and recurrent/multiphasic clinical progression, particularly in pediatric patients. This review summarizes the data regarding MOG-Ab as an impending biological marker for discriminating between these diverse demyelinating CNS diseases and discusses recent developments, clinical applications, and findings regarding the immunopathogenesis of MOG-Ab-associated disorders.

Pattern Extraction of EMG Signal of Spinal Cord Injured Patients via Multiscaled Nonlinear Processing (다중스케일 비선형 처리를 통한 척수 손상 환자의 근전도 신호 패턴 추출)

  • Lee, Y. S.;Lee, J.;Kim, H. D.;Park, I. S.;Ko, H. Y.;Kim, S. H.
    • Journal of Biomedical Engineering Research
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    • v.22 no.3
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    • pp.249-257
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    • 2001
  • The voluntary contracted EMG signal of spinal cord injured patients is very small because the information from central nervous system is not sufficiently transmitted to $\alpha$ motor neuron or muscle fiber. Therefore the acquisited EMG signal from needle or surface electrodes can not be identified obvious voluntary contraction pattern by muscle movement. In this paper we propose the extraction technique of voluntary muscle contraction and relaxation pattern from EMG signal of spinal cord injured patient whose EMG signal is composed of the linear sum of mo색 unit action potentials with two noise sources, additive noise assumed to be white Gaussian noise and high frequency discharge assumed to be not motor unit action potential but impulsive noise. In order to eliminate impulsive noise and additive noise from voluntary contracted EMG signal, we use the FatBear filter which is a nonarithmetic piecewise constant filter, and multiscale nonlinear wavelet denoising processing, respectively. The proposed technique is applied to the EMG signal acquisited from transverse myelitis patients to extract voluntary muscle contraction pattern.

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Enterovirus 71 infection: An experience in Korea, 2009

  • Kim, Kyung-Hyo
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.616-622
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    • 2010
  • Enterovirus 71 (EV71) has been recognized as a frequent cause of epidemics of hand-foot-and-mouth disease (HFMD) associated with severe neurological symptoms. In the spring of 2009, HFMD was epidemic in Korea. Severe cases with complication, including death, have been reported and it has become a public health issue. Most symptomatic EV71 infections commonly result in HFMD or herpangina. These clinical manifestations can be associated with neurologic syndromes frequently. Neurologic syndromes observed in EV71 include meningitis, meningoencephalomyelitis, poliomyelitis-like paralytic disease, Guillain-Barr$\acute{e}$ syndrome, transverse myelitis, cerebellar ataxia, opsoclonus-myoclonus syndrome, benign intracranial hypertension, and brainstem encephalitis. Examinations for EV 71 were performed from the stools, respiratory secretion or CSF of the children by realtime PCR. Gene analysis showed that most of them were caused by EV71 subgenotype C4a which was prevalent in China, 2008. Public health measures including personal and environmental hygiene, must to target daycare centers, kindergartens, and schools where highly susceptible children congregate. To prevent the spread of infection, preschools where transmission persists for more than 2 incubation periods, have been recommended for closure, and trigger criteria for voluntary closure was instituted. During closure, operators are to thoroughly clean the centers before they are allowed to reopen. In addition, parents are advised to ensure that their children adopt a high standard of personal hygiene and to keep the infected child at home until full recovery. Because the outbreaks occur in a cyclical pattern, surveillance system to predict next outbreaks and adequate public health measures to control need to be planned for future. Control of EV71 epidemics through surveillance and public health intervention needs to be maintained in Korea. Future research should focus on understanding of EV71 virulence, identification of the receptor(s) for EV71, development of antiviral agents and development of vaccine.

Meningovascular and Spinal form of Neurosyphilis Presenting as Multiple Cranial Nerve Palsy, Cerebral Infarction and Meningomyelitis in a Human Immunodeficiency Virus Negative-Patient: MR Imaging Features (인간면역결핍바이러스 음성 환자에서 뇌신경 마비, 뇌경색 및 수막척수염으로 발현한 신경매독의 자기공명영상 소견)

  • Hong, Jin Ho;Lee, Ha Young;Lim, Myung Kwan;Kang, Young Hye;Lee, Kyung Hee;Cho, Soon Gu
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.263-268
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    • 2014
  • Neurosyphilis is a rare infection of the brain and spinal cord caused by a spirochete named Treponema pallidum. We describe the magnetic resonance imaging of a 53-year-old man with syphilis who manifested as both meningovascular, and spinal meningomyelitic types, which involved the optic, trigeminal, facial and vestibulocochlear nerves, both middle and left posterior cerebral arteries, thoracic spinal cord and meninges of the lumbar spine. This case report suggests that neurosyphilis should be considered as a possible diagnosis in patients showing complex brain and spinal imaging features. These features include enhancing meningeal lesions with multiple cranial nerve involvement, stenoses in large to medium size cerebral arteries, and intramedullary and meningeal lesions of spine.

A Case of Influenza-associated Encephalopathy (인플루엔자 관련 뇌증 1례)

  • Song, Yeoni;Choi, Chang Hwan;Choi, Jong Woon;Kim, Se Young;Kim, Hyun Soo;Kim, Yeol;Im, Dong Jin
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1024-1028
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    • 2003
  • Influenza-associated encephalopathy is regarded as one of the major neurologic disease entities along with those of Reye syndrome, acute necrotizing encephalopathy, and myelitis which are known to be related to influenza virus, mostly type A. And it is being actively researched in Japan as it has caused a tremendous increase in the number of deaths from 1997 to 2002, but it has not been yet reported in the Korean pediatric medical community. It attacks those previously healthy children, who have not been vaccinated. Patients start with such symptoms as fever and common respiratory problems, but within 24 to 48 hours they suffer from seizures with acute mental deterioration, become worse, and suffer multiple organ failures including marked elevated transaminase levels as well as coagulopathy. It induces deaths in a couple of days after the symptoms appear or remains a serious neurologic sequelae. Confirmative diagnosis is used to demonstrate influenza viral infection. We report here a 37 month aged boy who was admitted to our hospital during the last influenza season under the diagnosis of influenza associated encephalopathy on the basis of serologic testing by hemagglutinin inhibition(HI). This is the first report confirmed by increased antibody titer of the influenza A virus in Korea.

A Case of Successful Pregnancy with Electroejaculation and In Vitro Fertilization (전기사정과 시험관아기시술에 의한 성공적인 임신 1례)

  • Nam, Y.S.;Kim, H.J.;Jun, Y.J.;Kim, H.K.;Oum, K.B.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.117-121
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    • 1999
  • Although anejaculation is a relatively uncommon occurrence in the general population, over 12,000 new cases are reported annually. Anejaculation may result from spinal cord injury, retroperitoneal lymph node dissection, diabetes mellitus, transverse myelitis, multiple sclerosis, or psychogenic disorders. At least 30% of men with this problem are or will be married and many will seek help to remedy their infertile state. The evolution of technique and instrumentation over the last 30 years has made electroejaculation an accessible and acceptable form of therapy. Recent successes in inducing ejaculation by means of rectal probe electrostimulation or vibratory stimulation combined with assisted reproductive techniques, such as zygote intrafallopian transfer (ZIFT), gamete intrafallopian transfer (GIFT), and in vitro fertilization (IVF), have provided these men means of producing their own biologic offspring. We have experienced a successful pregnancy with electroejaculation and in vitro fertilization in a infertile patient whose husband had an ejaculatory disturbance due to a spinal cord injury. So we report this case with a brief review of literatures.

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Cause of enteroviral infection in children in chungnam area summer, 2005 (2005년 하절기에 충남지역 소아에서의 장바이러스 감염원인)

  • Jeon, Se Yun;Choi, Suk Joo;Kim, Yong Bae;Nam, Hae Seon;Park, Kwi Sung;Baek, Kyung Ah;Park, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1186-1193
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    • 2006
  • Purpose : Enterovirus infection is a type of viral infection that occurs relatively frequently in children during summer. It has clinical symptoms of non-specific fever, aseptic encephalomeningitis, gastrointestinal diseases, skin rash and, hand-foot-mouth disease. However, it can also occcaisionally, result in fatal symptoms like myocarditis, epicardial inflammation, transverse myelitis, quadriplegia and etc. There have been epidemic enterovirus studies, but not in the Chungnam area. Therefore, we undertook this study in order to comprehend the cause viruses in this area. Methods: We enlisted 157 children hospitalized with enteroviral infections at Soonchunhyang University hospital in Cheonan between May and August 2005. Cerebrospinal fluids or feces were collected during the acute phase after hospitalization, and observed the cytopathic effects caused by enterovirus and using reverse transcription polymerase chain reaction (RT-PCR). Results : The number of children hospitalized due to possible enteroviral infection during the period of study was 157. The number of children who tested positive with the reverse transcription polymerase chain reaction totalled 32 cases (20.4 percent). Among the children with entroviral diseases, 20 were male and 12 were female, thus the sex ratio of male to female was 1.67:1. Their clinical symptoms included fever most frequently (93.7 percent), was followed by headaches (90.0 percent), meningeal irritation signs (65.0 percent), and abdominal pain (30.0 percent). As for the type of isolated enterovirus, there were 17 cases of echovirus 18 and 6 cases of coxsackievirus B5. Furthermore, there were 2 cases of echovirus 9, 1 case of coxsackievirus A6 and coxsackievirus B3, respectively. But 5 cases were not determined by genotype. Conclusion : Echovirus 18 is circulating in Korea. We reported on identified enteroviruses, including echovirus 18, using RT-PCR in the Chungnam area during the summer of 2005.